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麻醉中一种罕见但严重并发症的病例报告:硬膜外血补丁后蛛网膜炎。

Case Report of a Rare but Serious Complication in Anesthesia: Arachnoiditis Following an Epidural Blood Patch.

作者信息

Kalpers David, Jean Jérome

机构信息

Anesthesiology, Centre Hospitalier du Luxembourg, Luxembourg, LUX.

出版信息

Cureus. 2025 Jun 18;17(6):e86295. doi: 10.7759/cureus.86295. eCollection 2025 Jun.

Abstract

The epidural blood patch (EBP) is an invasive technique used to plug a leak of cerebrospinal fluid, usually following an iatrogenic lesion of the dura mater. This injection of autologous blood into the epidural space is associated with a number of rare but potentially serious complications. We present a case of arachnoiditis in a young parturient who presented with symptoms compatible with intracranial hypotension due to an accidental dural puncture during an obstetric epidural, and who was treated with two epidural blood patches. The diagnosis of arachnoiditis was suspected based on the neurological symptoms and confirmed by magnetic resonance imaging (MRI) of the lumbosacral region. Monitoring after an EBP and potential treatment options for spinal arachnoiditis are a current topic of discussion in anesthesia.

摘要

硬膜外血贴疗法(EBP)是一种侵入性技术,通常在硬脑膜发生医源性损伤后用于封堵脑脊液漏。将自体血注射到硬膜外间隙会引发一些罕见但可能严重的并发症。我们报告一例年轻产妇发生蛛网膜炎的病例,该产妇因产科硬膜外麻醉时意外硬膜穿刺出现与颅内低压相符的症状,并接受了两次硬膜外血贴治疗。根据神经症状怀疑为蛛网膜炎,并经腰骶部磁共振成像(MRI)确诊。硬膜外血贴治疗后的监测及脊髓蛛网膜炎的潜在治疗方案是目前麻醉领域讨论的话题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e23/12275493/8018a557f0da/cureus-0017-00000086295-i01.jpg

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